Canyonlands Community Health Care
Clinic/Center, Community Health in Page, AZ. Organization (NPI-2).
NPI number1619945904
StatusActive
Last updated in NPPESSep 23, 2021
Details
- NPI
- 1619945904
- Entity type
- Organization (NPI-2)
- Legal business name
- Canyonlands Community Health Care
- Organization subpart
- Yes
- Enumeration date
- Mar 10, 2006
- Certification date
- Sep 23, 2021
- Last updated
- Sep 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QC1500X | Clinic/Center, Community Health | OTC 0127 | AZ | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 207R00000X | Internal Medicine | – | – | |
| 207V00000X | Obstetrics & Gynecology | – | – |
Other names
- Lake Powell Medical Center (Doing Business As)
Practice location
467 Vista AvenuePage, AZ 86040-1625
Phone 928-645-8123 · Fax 928-645-3862
Mailing address
Po Box 1625Page, AZ 86040-1625
Phone 928-645-9675 · Fax 928-645-3030
Authorized official
Christopher J Hansen
Ceo
9286459675
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